Interscalene Brachial Plexus Block: Comparison of Efficacy of Varying Doses of Dexamethasone Combined With Levobupivacaine: A Double-Blind Randomised Trail.

Nallam, Srinivasa Rao

doi:10.14260/jemds/2014/2836

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…Similarly, Cummings et al [ 15 ] also observed that dexamethasone significantly prolonged the duration of ropivacaine and Bupivacaine when used for the inter-scalene block. Nallam [ 16 ] in their study comparing the various doses of dexamethasone (4 mg = low, 8 mg = high), found similar efficacy of analgesia prolongation in the inter-scalene block when used with levobupivacaine with the lower requirement of analgesia in first 48 hours in both groups. Similar comparative studies of different doses of dexamethasone in lower limb blocks are lacking, prompting us to undertake this study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 4 mg dexamethasone versus 8 mg dexamethasone as an adjuvant to levobupivacaine in fascia iliaca block-a prospective study

2018

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BackgroundTo compare the effects of adding two different doses of dexamethasone on the duration and quality of the fascia iliaca block in patients undergoing proximal femoral fracture surgery.MethodsA total of 60 patients (age 18–70 years) undergoing proximal femoral nailing surgery under spinal anesthesia were given fascia iliaca block after random assignment to one of the two groups: Group H received an injection of levobupivacaine (0.5%) 28 ml with 2 ml (8 mg) dexamethasone, and Group L received an injection of levobupivacaine (0.5%) 28 ml with dexamethasone 1 ml (4 mg) with 1 ml normal saline. Assessment of the duration of analgesia and the total tramadol requirement over 48 hours were noted after a successful block.ResultsThe duration of analgesia was found to be significantly longer in Group H (17.02 ± 0.45 h) than in the Group L patients (14.29 ± 0.45 h) with a p-value of 0.000. Postoperative analgesic requirement (amount of tramadol in mg) was significantly higher in Group L (Q2: 200.0; IQR: 100.0, 200.0) as compared to Group H (Q2: 100.0; IQR: 100.0, 200.0) with a p-value of 0.034. No patient showed any sign of neurotoxicity.ConclusionsDexamethasone, in a dose of 8 mg, is superior to 4 mg when used as an adjuvant with levobupivacaine in the FIB. Though both prolonged analgesia and were effective in reducing oral/intravenous analgesics, 8 mg dexamethasone can be recommended as a more efficacious adjuvant to local anesthetics in the FIB.

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Section: Discussionmentioning

confidence: 99%

Comparison of 4 mg dexamethasone versus 8 mg dexamethasone as an adjuvant to levobupivacaine in fascia iliaca block-a prospective study

2018

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Dexamethasone as an adjuvant to peripheral nerve block

Pehora

Pearson

Kaushal

et al. 2017

Cochrane Database of Systematic Reviews

163

127

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Low- to moderate-quality evidence suggests that when used as an adjuvant to peripheral nerve block in upper limb surgery, both perineural and intravenous dexamethasone may prolong duration of sensory block and are effective in reducing postoperative pain intensity and opioid consumption. There is not enough evidence to determine the effectiveness of dexamethasone as an adjuvant to peripheral nerve block in lower limb surgeries and there is no evidence in children. The results of our review may not apply to participants at risk of dexamethasone-related adverse events for whom clinical trials would probably be unsafe.There is not enough evidence to determine the effectiveness of dexamethasone as an adjuvant to peripheral nerve block in lower limb surgeries and there is no evidence in children. The results of our review may not be apply to participants who at risk of dexamethasone-related adverse events for whom clinical trials would probably be unsafe. The nine ongoing trials registered at ClinicalTrials.gov may change the results of this review.

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Regional anaesthesia for surgical repair of proximal humerus fractures: a systematic review and critical appraisal

Iliaens

Metsemakers

Coppens

et al. 2019

Arch Orthop Trauma Surg

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Interscalene Brachial Plexus Block: Comparison of Efficacy of Varying Doses of Dexamethasone Combined With Levobupivacaine: A Double-Blind Randomised Trail.

Cited by 3 publications

References 27 publications

Comparison of 4 mg dexamethasone versus 8 mg dexamethasone as an adjuvant to levobupivacaine in fascia iliaca block-a prospective study

Comparison of 4 mg dexamethasone versus 8 mg dexamethasone as an adjuvant to levobupivacaine in fascia iliaca block-a prospective study

Dexamethasone as an adjuvant to peripheral nerve block

Regional anaesthesia for surgical repair of proximal humerus fractures: a systematic review and critical appraisal

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